Friday, July 25, 2014

Mtx: 4, Hope: 0

Skunked, 4-0. Even her amazing super girl ballerina outfit didn't protect her.



It was just too toxic for her, even at the 50% dosage she got a mouthful of nasty sores. We came home after 5 days, but ended up back in the hospital for 2 more nights because of pain and low blood sugar from no eating. Home for good on Wednesday, with a few nights of IV fluids here to see her through the rest of the mucositis. 


But the good news is that, after 41 nights in the hospital since Memorial Day, she's finally done with methotrexate in that form. (There will be weekly oral doses of mtx during maintenance, and many more lumbar punctures with mtx...)

Now she has two weeks to recover before the last intense phase of treatment, Delayed Intensification (aka Everything But the Kitchen Sink).


Tuesday, July 15, 2014

Toes


H: I paint
M: OK, do you want to paint with your fingers or a brush?
H: Feet!

So this happened...




Friday, July 11, 2014

The big thaw

We left the hospital Friday afternoon. Coming home is always a bit of a challenge. Hope is excited on arrival but then clingy and tentative for a few days. We've spent so much of the last two months in the hospital that I think she misses its routines, rhythms and personalities.

I find the transition a challenge too. The first 24 hours feel like a great thaw. It's always jeans-and-sweatshirt weather at Hopkins. We've watched winter turn into spring and spring to summer through the giant windows - but we haven't felt it much. I like to come home and sit on the stoop in the blistering sun.

But there's another numbness that I need to melt away - and it makes the quick transitions more difficult. The beautiful toddlers and preschoolers with wispy bald heads don't seem out of the ordinary to me anymore. With other parents and hospital staff, we trade stories about the cute things they say, weird foods they eat, their little kid "crushes" on a favorite nurse or doc. Their diseases, the scheduled poisons or complications that led to their admissions, are forgotten to make the days and weeks in the hospital bearable. The teens whose diagnoses I can only guess at stay behind closed doors, while their tight-lipped parents smile at the little ones doing laps around the unit. 

These few days at home allow for a thaw of this protective shell - to feel the sadness and fear of these realities before we jump back in. 

Wednesday. It's her last scheduled admission, for a 50% reduced dose of methotrexate. 

Monday, July 7, 2014

It's like déjà vu all over again

Yesterday was not a good day. We had a hard time getting on top of the pain. She had some nice distractions though - and that helped. The Child Life Specialist brought in shaving cream and finger paints for some messy fun.


And a music education student from Peabody brought some instruments and musical games.


But really it was this kind of overwhelming today:


Looks like maybe her counts are starting to creep back up, so healing may follow...

Wednesday, July 2, 2014

Mtx, Round 3

Hope had a good week at home with lots of World Cup (and Barney), Lunchables, fun with Celia and Quinn, and some cooking with me...


We returned Wednesday morning for round 3 of the epic battle: Hope vs. Methotrexate. When we left last week, the general consensus seemed to be that her mucositis earned her another dose reduction of 25%. But in the team's rehashing of events (particularly the continuous intake of Lunchables) they decided to stick with the same dosage as round 2. It's good and bad news. 

On the one hand, we want her to get enough  to do the job. One doc told us yesterday that when they added this phase of high-dose mtx to the protocol a few years ago they saw EFS (event free survival) rates rise 10% - an amazing increase for childhood leukemia given how high these rates already were by that time. (Hope's dose is intermediate dose because of her Ds.) We want that payoff.

But, on the flip side, she will almost certainly get mucositis again. Hopefully its severity and the placement of the sores won't prevent her from eating and drinking. And, of course, our stay is likely to be extended by a few days. Last time it took a week, so that's a reasonable estimate.

This round started with another trip to the 4th floor OR for a lumbar puncture with chemo. Needless to say, Hope has many friends in pre-op, so she spent part of the wait doing some "work" at the nurses' station with her friend Serenti.


The 24-hour methotrexate infusion started at 10 pm. After a middle-of-the-night port fiasco (that required re-accessing her port because she pulled the needle out and dressing off while sleeping), it has been uneventful so far. Many laps around the unit, painting in the playroom, a lovely visit from Dorothy and Mags, and dinner with everybody. 


Clearance and the waiting start tomorrow.